The Hand to Shoulder Solution
Your new resource for hand, shoulder, and elbow pain. Together, we are giving pain the middle finger and gaining knowledge to live a better, pain-free life!
Discover what might be causing pain in your fingers, pain in your hand, pain in your wrist, pain in your arm, pain in your elbow, pain in your shoulder.
Learn about your body, arthritis, tendinitis, tennis elbow, fractures, golfer's elbow, and carpal tunnel syndrome.
Hosted by Carl Petitto, OT, CHT, and Certified Hand Therapist specializing in orthopedic conditions of the hand to shoulder. Also an expert in fabricating custom orthotics.
The Hand to Shoulder Solution
Inside Bursitis: What Hurts, Why It Hurts, and How to Calm It Down
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Hello and welcome to the show, The Hand to Shoulder Solution, with me, Carl Petitto.
If you are experiencing pain in your arms and hands, this is your resource.
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This is a resource to help you mitigate pain at home and become more educated on what to ask your doctors and therapists. No medical advice will be given, and you should always see your medical professional for any questions.
Thank you, and welcome to the show!
Welcome back to the Hand to Shoulder Solution, giving pain the middle finger. I'm your host, Carl Petito. Today I want to talk about shoulder pain and specifically pain in the front of your shoulder. And one condition that I would like to discuss is bursitis, B-U-R-S-I-T-I-S. And there's the itis again. Itis means inflammation. In this case, it's inflammation of the bursa sac. And I'm going to explain what that is. Firstly, I want to state that it is crucial that you be seen by a healthcare professional to very accurately diagnose exactly what's causing your shoulder pain. The mechanics of the shoulder is very complex. There's a lot of moving parts, and it needs to be teased out and figured out exactly what's causing the pain. And there's many different things that could cause pain in the front of your shoulder. So you can have a diagnosis of bursitis, but there's also differential diagnosis. There's different diagnoses that could also be causing the same problem. But let's stick with bursitis for today's episode. So the bursa sac, what is it? You can think of it like a little flat water balloon, and that lives underneath this roof of bone and on top of the ball of the ball and socket. This roof of bone is part of the shoulder blade, and the shoulder blade has the socket in it. So the socket is actually part of the shoulder blade. Now this bursa sac that's right there, the flat water balloon, the balloon part of the water balloon, is living tissue. And that living tissue gets inflamed, hence bursitis. So how do we decrease the inflammation? Let's talk about the mechanics first. As a therapist in the clinic, I'm going to do some manual therapy techniques. For example, traction, I'm going to pull the arm and pull the head of the socket down to cause the negative pressure, pull in some nice nutrient-rich fluids into the joint space to bring more oxygen, more nutrients to the tissues in the area. I'm also going to push the ball back and forth, loosen things up. The shoulder blade, usually the muscles that attach the shoulder blade to the rib cage get very, very tight and they prevent the shoulder blade from rotating. In previous episodes, I talked about mechanics of the shoulder, and if that shoulder blade isn't rotating properly, when you raise your arm, this roof of bone does not move up out of the way. And you get pinching right there, and it squeezes that bursa sac. And that starts causing irritation. So after I stretch the shoulder blade in multiple different directions, I also want to give my patients exercises to do at home to strengthen specific groups of muscles that will do two things that will pull the head of the humerus, the ball, downward and raise the shoulder blade. That restores the space here, taking pressure off that bursa sac, that thin little water balloon that's irritated, and allow that to start to heal, allow it to start to calm down. In addition to that, at home, what I have folks do is put their hand behind their back that exposes that bursa sac. So watch this. So if you put your hand behind your back, that rolls the shoulder ball forward and it pulls the sack forward because remember, that bursa sac lives underneath that roof of bone. So you can pull it forward, and now it's exposed in the front. So there's a there's uh one way we diagnose it in the clinic is I'll have the patient put their hand behind their back, literally touch on the front of the ball, and if that's really sore, and that you know, usually people jump, then that's a clear indication that they have bursitis. So you can do that to yourself. Put your hand behind your back, feel that right there. You can feel the roof of bones slide down a little bit and touch right there, and if that's really, really sore, you probably have bursitis. Now, at home, patients will hold an ice cube with a napkin or something or a cloth, and then just barely touch the ice cube with the hand behind the back to the skin, and the goal is only to get it cold. So obviously, an ice cube is hard as a rock. You don't want to rub it on there hard, it would aggravate it more. But cold shrinks, and cold will shrink down that inflammation. So ice directly on the skin, around the front round part of the shoulder, only until deeply cold, which should take 10 to 20 seconds. And then set the ice cube down, you can just lay your hand on it, let it go warm again, and then one more round of it, 10 to 20 seconds, deeply cold, done. Midday and at the end of every day. And I tell folks, if they can only do it once per day because they're too busy, at least do it at the end of the day. Because at the end of the day, after you've been using your hands and arms all day long, that's when the inflammation is going to be highest, that's when things are gonna be most aggravated. So let's recap real quick. Hand behind your back, touch it. If it's really, really sore, then it's probably bursitis. Nice icing. Again, expose the burst of sack by putting your hand behind your back, ice directly to the skin, only until deeply cold. That reduces the inflammation. You should also be seen in the clinic so the mechanics of this can be fixed, fixed, like we talked about on the beginning of the episode. Thank you very much for watching. Thank you for liking the episode and subscribing to the channel.